Provider Demographics
NPI:1811464290
Name:SYMMETRY SPORTS LLC
Entity type:Organization
Organization Name:SYMMETRY SPORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-305-4308
Mailing Address - Street 1:100 SYLVAN RD STE 725
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1800
Mailing Address - Country:US
Mailing Address - Phone:781-305-4308
Mailing Address - Fax:781-305-4309
Practice Address - Street 1:100 SYLVAN RD STE 725
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1800
Practice Address - Country:US
Practice Address - Phone:781-305-4308
Practice Address - Fax:781-305-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty